On Our Own Again

For the last five weeks or so since Dad has been out of the rehab hospital, he’s been getting nursing and physical therapy care at home, through the visiting nurse association. A nurse has come a couple times a week to change the dressing on his toe wound, and the physical therapist has come a couple times a week to work with Dad on mobility issues. Additionally, we’ve had an electronic health station, complete with scale, blood-pressure cuff and that little finger doohickey that checks heart rate and blood oxygen – it’s connected to a cell-phone modem and sends the daily vital-sign readings to a telemedicine monitoring office, staffed with nurses who review the readings as they come in.

When it first started it was a bit overwhelming to me, having all these people calling, coming into the house, and dealing with the daily exercise of taking Dad’s vital signs. But the value of this added medical attention soon became apparent, as Dad’s blood pressure started to go a little wacky. Blood pressure is, as they say, a silent killer – you don’t feel all jittery like you do when your blood sugar is too high, and you don’t get any minor chest pains, as with angina. You only know your blood pressure is high by measuring it regularly. Whenever Dad’s readings would get much above 160 (for the high number), we’d get a call from the telemedicine nurse asking us to retest. And the physical therapist generally took it before and after any exercise – the times it was 180 or higher after just a 20-foot walk to the bedroom where the machine was, she’d be on the phone to telemedicine or to the nurse at Dad’s doctor’s office. It was through such calls that the doctor knew Dad’s blood-pressure-medicine prescription needed to be increased.

Well, all that is over now. Once Dad got his license and began driving again, the VNA had to discharge him – the services, which are covered by Medicaid, are intended only for homebound patients. So, Cindy the physical therapist came by for her last session last week, the nurse had her last visit a couple days ago (during which she checked out my dressing technique for Dad’s toe), and a technician came by this morning to pick up the telemedicine monitor.

In preparation for losing the monitor, Dad stopped by CVS yesterday to get a digital blood-pressure cuff, and already I see how this will play out now that the professionals are out of the daily picture. He measured himself yesterday afternoon and got a reading of 188/65. Of course this meant the machine was “all screwed up.” Later that evening I learned that he’d taken himself to lunch and had a full order of beer-battered Polish sausage – individual slices of salt-laded sausage, dipped in a salty beer batter and then deep fried. Who knew you could get a meal like this anyplace but at a Midwestern state fair?

In the past, I might have gone ballistic at hearing that – all “What the hell were you thinking?”, “Do you know how many days’ worth of salt you ate?” and “Why do I even bother with all this work reading labels and trying to find decent low-sodium recipes?” – but knowing that the day would come when I wouldn’t have a medical professional to rat him out to within a day or so, I’ve tried to teach myself the five-deep-breaths method of confrontation avoidance (it is helpful if one has a freshly shaken gimlet nearby to occupy oneself between those five breaths). I took my breaths (between gimlet sips) out in the kitchen, noted that we can probably be sure the new machine is not “all screwed up,” and let it go.

When I tested the machine out on myself this morning, I got the lowest reading I’ve had since the telemedicine monitor was first installed. I used to use that machine on myself when Dad was out at poker, to see how my own blood pressure doing. The first few times it was as high as the 130/80, which was kind of scary, especially seeing as it had been 112/60 at my physical last year. But this morning it was back down to a much more acceptable 115/60, a good sign that, just maybe, I’m getting better at not letting Dad’s inability to manage his own blood pressure drag mine along with his, up through the stratosphere.

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One Response to “On Our Own Again”

Chuck,As you know I'm going through much the same-only congestive heart failure meds adjustments with my Dad.At least you have understood blood pressure readings.In upstate NY the state of the art communication is weekly visits to the VA center near my Dad's rural home, reports sent to his VA doctor.And he writes letters every month to his heart doctor at the other end of the state. Last visit I tried, in vain to explain why this is a very weak communication system and HIPPA ("Why the doctors know each other and are friends. There's no problem" says my Dad.Plus he just thinks its a lot of women bossing him around because they are worried and you can almost see his blood pressure rising during the conversation. Unfortunately I think this is part of the letting go-the other person thing right?